MEDICARE: SUEANN SHEN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	183500000X	Pharmacist	51875	TX

General Provider Information

NPI Number	:	1043812670
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SUEANN SHEN

Provider Business Mailing Address
First Line	:	6203 ELM HEIGHTS LN
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77081-2425
Country	:	US
Telephone Number	:	713-829-6572
Fax Number	:

Provider Business Practice Location Address
First Line	:	13484 NORTHWEST FWY
Second Line	:
City	:	HOUSTON
State	:	TX
Zip	:	77040-6007
Country	:	US
Telephone Number	:	713-690-6696
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	11/09/2020
Last Update Date	:	11/09/2020

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Directions to “ SUEANN SHEN ” Practice Location

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